scholarly journals Correlation of HbA1c with urinary ACR, serum creatinine and eGFR in type-2 diabetes mellitus at Puducherry, South India

Author(s):  
Vithiavathi Sivasubramanian ◽  
Karthik Jetty ◽  
S. Senthil Kumar

Background: Diabetes Mellitus (DM) is a major emerging clinical health problem in this world. Anemia is a common problem in diabetes. Type 2 DM comprises about 90% of diabetic population of any country.Methods: A cross-sectional study carried out among 125 type 2 diabetic mellitus patients’ area at Department of Medicine Aarupadai Veedu Medical college (AVMC) and hospital, Puducherry during the period from May 2018 to October 2018.The objectives of the study were to evaluate the association of HbA1c with urinary ACR, eGFR and serum creatinine in Type 2 diabetes mellitus. Data was analyzed using the SPSS version 20.0 software.Results: The randomly selected study group comprised 100 type 2 DM patients and 25 control peoples of 35-70 years of age. Type 2 DM patients were evaluated of HbA1c, normotensives or hypertensives. FBS, serum creatinine, urinary albumin and creatinine were estimated. Urinary ACR and eGFR and were calculated. The data result was expressed as mean and standard deviation. A probability value is less than 0.05 and it was considered statistically significant.Conclusions: Type 2 diabetes mellitus patients, HbA1c and duration of diabetes were the strongest predictors of micro albuminuria and age was the strongest predictors of a low eGFR. The diabetes was poorly controlled, making the progression to end stage renal failure in concern patients. They measure the prevention of urinary albumin excretion, development of renal abrasion, smoking termination, strict glycaemic control and initiating lipid lowering therapy.

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030344
Author(s):  
Miguel Angel Salinero-Fort ◽  
Jose M Mostaza-Prieto ◽  
Carlos Lahoz-Rallo ◽  
José Ignacio Vicente Díez ◽  
Juan Cárdenas-Valladolid

ObjectivesTo evaluate the risk profile, achievement of cardiometabolic goals, and frequency and optimal use of cardiovascular preventive therapies among nonagenarians with type 2 diabetes mellitus (T2DM). To investigate possible sex differences.Design and settingA cross-sectional population study of 11 645 persons aged ≥90 years with T2DM living in Madrid (Spain). Sociodemographic, clinical and therapy profiles were collected through electronic records in primary care. We considered antihypertensive therapy and lipid-lowering therapy to be optimal when known patients with hypertension with albuminuria received renin–angiotensin system blockers and statins had been prescribed for overt cardiovascular disease.ResultsThe prevalence of coronary artery disease was higher in males than in females (21.5% vs 12.6%, p<0.01), as was that of peripheral artery disease (8.5% vs 2.3%, p<0.01). However, the prevalence of cerebrovascular disease was similar in both sexes (16.5% vs 16%; p=0.44). Haemoglobin A1c was lower than 7% in 64.4% of cases, with female predominance in patients with known dementia (67.1% female vs 59.9% male; p<0.01). Antiplatelet therapy was significantly more frequent in males than in females (48.1% vs 44.3%; p<0.01), as were statins (43.2% vs 40.2%; p<0.01). Both in primary and in secondary prevention, rates for simultaneous achievement of the HbA1c, blood pressure, LDL-C goals were significantly lower among females (p<0.01). For each criterion of optimal use of cardiovascular preventive therapies, adherence was significantly better in males than in females.ConclusionOur study showed that the risk of cerebrovascular disease was similar in both male and female Spanish nonagenarians. Adherence was poorer in females for all criteria of optimal use of cardiovascular preventive therapies. Our findings indicate that the known sex differences in younger patients with T2DM persist in patients aged ≥90 years. There is considerable room for improvement in standards of preventive care in nonagenarians with T2DM, especially in females.


2021 ◽  
Vol 2 (1) ◽  
pp. 23-28
Author(s):  
Alexander Petra Sihite ◽  
I Gusti Ngurah Pramesemara ◽  
I Wayan Surudarma

Background: Type 2 diabetes mellitus is a metabolic disease that characterized by high blood sugar levels. This condition is often not noticed immediately and usually patient starting to realize it when complications have been occurred. A long-term complication of type 2 DM that occurred in men is erectile dysfunction (ED). ED is a condition when a person is unable to achieve or maintain an erection for sexual intercourse. One factor that influence the occurrence of ED and its severity in type 2 DM patients is the duration of the disease. Objective: The aim of this study was to determine the relationship of type 2 DM duration and the occurrence of ED. Methods: This study is an observational analytic cross-sectional study conducted at the Puskesmas (Public Health Center) Denpasar Barat I. The research data was obtained through medical record data and fill the International Index of Erectile Function (IIEF-5) questionnaire on 36 type 2 DM patients aged around 40-60 years. The statistical analysis used was Fisher's exact test. Results: The results showed that of the 36 samples, 19 (52.8%) samples had type 2 DM <24 months and 17 (47.2%) samples had type 2 DM >24 months. It was found that 5 (13.9%) samples did not experience ED while the rest experienced ED with different severity. There was a significant relationship between the type 2 DM duration and the occurrence of erectile dysfunction at Puskesmas Denpasar Barat I (p = 0.022). Conclusion: Study has found that type 2 DM patients with the longer duration (>24 months)  have a higher occurrence of ED and tended to be more severe compared to those with shorter duration (<24 months). Further studies should be performed with higher number of patients and more controlled risk factor so it will be more accurate in determining the relationship between the duration of type 2 DM and ED.


2017 ◽  
Vol 66 (4) ◽  
pp. 747-754 ◽  
Author(s):  
Oana Milas ◽  
Florica Gadalean ◽  
Adrian Vlad ◽  
Victor Dumitrascu ◽  
Cristina Gluhovschi ◽  
...  

MicroRNAs (miRNAs) are short non-coding RNA species that are important post-transcriptional regulators of gene expression. The aim of the study was to establish a potential explanation of podocyte damage and proximal tubule (PT) dysfunction induced by deregulated miRNAs expression in the course of type 2 diabetes mellitus (DM). A total of 68 patients with type 2 DM and 11 healthy subjects were enrolled in a cross-sectional study and assessed concerning urinary albumin:creatinine ratio (UACR), urinary N-acetyl-β-D-glucosamininidase (NAG), urinary kidney injury molecule-1, urinary nephrin, podocalyxin, synaptopodin, estimated glomerular filtration rate (eGFR), urinary miRNA21, miRNA124, and miRNA192. In univariable regression analysis, miRNA21, miRNA124, and miRNA192 correlated with urinary nephrin, synaptopodin, podocalyxin, NAG, KIM-1, UACR, and eGFR. Multivariable regression analysis yielded models in which miRNA192 correlated with synaptopodin, uNAG, and eGFR (R2=0.902; P<0.0001), miRNA124 correlated with synaptopodin, uNAG, UACR, and eGFR (R2=0.881; P<0.0001), whereas miRNA21 correlated with podocalyxin, uNAG, UACR, and eGFR (R2=0.882; P<0.0001). Urinary miRNA192 expression was downregulated, while urinary miRNA21 and miRNA124 expressions were upregulated. In patients with type 2 DM, there is an association between podocyte injury and PT dysfunction, and miRNA excretion, even in the normoalbuminuria stage. This observation documents a potential role of the urinary profiles of miRNA21, miRNA124, and miRNA192 in early DN. Despite their variability across the segments of the nephron, urinary miRNAs may be considered as a reliable tool for the identification of novel biomarkers in order to characterize the genetic pattern of podocyte damage and PT dysfunction in early DN of type 2 DM.


Author(s):  
Prashant P. Shivgunde ◽  
Shantanu R. Joshi ◽  
Archana D. Kodilkar

Background: Diabetes is a chronic metabolic disease which affects the quality of life. It leads to multiple complications due to metabolic involvement. Out of multiple drugs used to treat diabetes, dipeptidyl peptidase 4 (DPP-4) inhibitors are comparatively new drugs used for type-2-diabetes mellitus (DM) treatment. This study aimed to find out the drug utilization (DU) 90% and use of DPP-4 inhibitors in patients with type-2-DM.Methods: A prospective, cross-sectional, observational study was conducted at a private healthcare clinic of an endocrinologist in Nashik. Type-2-DM patients of both sexes were selected and a total of 199 patients were enrolled in the study. The consented patients were interviewed and prescription copies were collected. After studying them; statistical analysis was done and results and conclusions were drawn.Results: Out of total prescribed drugs, 58.77% of drugs were anti-diabetics. It was observed that the biguanides were most frequently (25.32%) prescribed while the least prescribed drugs were meglitinide analogues (0.08%). Most commonly utilized anti-diabetic found to be metformin. Vildagliptin 50 mg is the most commonly prescribed drug from DPP-4 inhibitors. Most of the drugs from the DPP-4 inhibitor group came under DU90%.Conclusions:DPP-4 inhibitors are showing wide acceptability by endocrinologists for type-2-DM management, according to this study. Performing repetitive drug utilization pattern study and circulation of standard treatment guidelines to practising physicians can be required. To emphasize the point on generic prescription, more awareness should be created. So that these can responses to further cost-effective and rational prescribing practices. 


2020 ◽  
Vol 2 ◽  
pp. 26-30
Author(s):  
Sangeetha Roslind ◽  
Kunnummal Muhammed ◽  
K. G. Sajeeth Kumar

Objectives: The objectives of the study were (1) to study the cutaneous manifestations in patients with type 2 diabetes mellitus (DM) in comparison to normal subjects and (2) to document the association between cutaneous manifestations and complications of DM. Materials and Methods: In this 1-year comparative cross-sectional study, 100 patients receiving treatment at the diabetic clinic of a tertiary center were evaluated for cutaneous manifestations and complications due to diabetes. The cutaneous features in diabetics were compared with that of normal controls. An attempt was made to find out any association between cutaneous features of DM and internal organ involvement due to diabetes. Results: Cutaneous manifestations were more frequent in patients with type 2 DM than normal controls. The most common manifestation in diabetics was fungal infection followed by bacterial infection. Diabetic dermopathy was found to have statistically significant association with nephropathy, retinopathy, and neuropathy due to type 2 DM. Limitations: Limited sample size and study confined to a tertiary referral center. Conclusions: Dermatology manifestations provide important clues of prognostic significance in type 2 DM.


Author(s):  
Krishan Kumar Meena ◽  
Praveen Sharma ◽  
Swati Srivastava ◽  
Uma Kumari Meena

Introduction: Diabetes mellitus (DM) is common metabolic disorder leading to various complications including micro-vascular complication. Diabetes and thyroid dysfunction can result in abnormalities of one another, as both are strongly implicated in cellular metabolism.  Aim of study was to establish any association between hypothyroidism and micro-vascular complications in patients of type 2 DM. Material and Methods: This Hospital based Cross sectional analytical Study was included 80 Euthyroid and 80 hypothyroid patients of type 2 DM. These patients were subjected to fundus examination (for retinopathy), urine for spot albumin and creatinine ratio and routine microscopy (for nephropathy), clinical examination and NCV (for neuropathy). Results: Age of patients ranged from 30 – 80 years. Most patients had duration of Diabetes > 5 years. Diabetic retinopathy was found in 15% Euthyroid and 37.5% Hypothyroid diabetics (p=0.002). Neuropathy was more in Hypothyroid (35%) as compared to Euthyroid (12.5%) patients (p=0.003). Prevalence of Nephropathy was also significantly more (p=0.011) in Hypothyroids (60%) as compared to Euthyroid (38.75%). Conclusion: Significant association was found between hypothyroidism and micro vascular complications in type 2 Diabetes mellitus. Screening of diabetics for thyroid functions is essential to reduce morbidity. Keywords: Diabetes, thyroid, retinopathy, neuropathy, nephropathy


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